My husband is getting brachytherapy in September and then IG IMRT in October. He is currently on Orgovyx for month two and will be adding zytega next month. Good news is that his PSA has gone to 2 and Testosterone to 9 after a month on Firmagon so meds seem to be doing what are supposed to.
Drs have prescribed Cialis and Viagra for ED. So far he doesn’t have it but I’m sure he will after the radiation and continuation of the meds. My concern is that the ADT meds already comprise the heart. Will adding the ED meds further compromise his heart? He doesn't have any cardiac issues. Wondering may be not take the ED meds at all? Want any input on the topic.
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SherryKahn
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I can't remember, is your husband metastatic to bones? Why not triplet therapy which is basically what you're doing but with Docetaxel chemo as well? I see your husband's PSA is not zero yet. Good questions about ED medicine. Thinking about this myself I focus on "this is a new day". And how many new days can I live? And yesterday is yesterday.
It’s in my bio. He is stage 4 A with possible seminal vessel and right nodule invasion as they came lit up in the psma scan. This is the treatment they have prescribed so far as the first line. Started it last month.
My question about zero PSA may not be applicable in your case. Because as you have mentioned your husband is not metastatic to bones. I apologize for asking a question that may not be appropriate.
may you and he enjoy a wonderful life of intimacy and sex in the setting of your love. Don’t surrender that! If he is not on nitrates for heart issues or such then there is no problem with Cialis or Viagra. Try a low dose first then adjust to full effect if no problems. Hundreds of millions use it without problems. Does not adversely effect prostate cancer. Enhances sex and intimacy when needed.
The potential negative impact of Cialis and Viagra are negligible compared to the ADT drugs, and don’t add any ‘compromising’ of the heart as you refer to it.
The ADT need not compromise the heart much at all if he is good heath now. Where these drugs concerned this specifically means having a healthy body composition, no existing co morbidities, and plenty of exercise.
ADT deteriorates the body in various ways, heart health is but one. Exercise, both cardiovascular and weight bearing, is the prime intervention, and it is essential. Being sedentary exacerbates any fatigue and creates far greater risk than anything he is taking, ED drugs included.
However If his habits are strong, he needs only to keep it up and eat a bit less due to slowed metabolism and the threatening visceral fat gain that it tends to induce. The ED drugs can help quite a bit also. Great luck to you!
I would strongly advise Cialis over Viagra, unless they’ve improved the side effects. Viagra had extreme flu-like symptoms for me and friends I have talked to.
Dosing is another iterative process. Take the minimum you need and figure out how long til it’s effective. I dissolve half a 20 mg in my mouth and things get perky in 45-60 minutes. Mild skin flushes, mild stuffy nose. Occasional mild headache. With ADT or nerve damage, sometimes the meds give erections that come and go.
You could skip meds entirely and go to injectable Trimix. My GF is 70 and never had kids, so penetration became more problematic over time anyway. With Trimix, you get a sustained erection in about 15 minutes, including preparation. Lasts 1-2 hours. I am still figuring out ideal dose. Want full erection given circumstances, but don’t want to risk priapism (longer than 2-4 hours).
Good luck with everything!
I’ve done them all…viagra, cialis, trimix, and a $35 elect pump with ring from Amazon works best…No drug hangover, and no jabbing yourself with a needle..,Works great…Just lube it and turn it on…there are vids on YouTube on how to use…,
the problem with ADT and other testosterone blockers is not so much function as interest. I always had way more interest in sex than my wife. After beginning therapy I had zero interest. I no longer noticed beautiful women. I still loved my wife, however. Was happy to try and make love but it was not the same.
So true.....................(Putting your dick, before you fix your sick). REMEMBER DOC, IT'S MY PENIS TOO.... ALL 2 INCHES OF IT (p.s. Thanks for the laugh)....
I've dealt with a heart issue -- atrial fibrillation. Even before I had a-fib ablation surgery I would take viagra or cialis with no problem. Low dose cialis is suggested to maintain penile health and prevent atrophy. That is a use apart from its more conventional use to solve ED sexual problems. You can get GoodRx coupons to get cialis cheaply.
Afib here. Brachy, IMRT, ADT, too. Know his interest in all things sexual will likely be zero. BUT, if he wants to plan ahead - hopefully, at some point, all of this will be a distant and unpleasant memory - he should consider ED meds now. Got to keep the blood flowing. Don't know if docs told you this but genital shrinkage (along with a bunch of other nasty side effects) may also occur. So, anything he can do to mitigate PCa treatment, the better. I'd also suggest that he get a penis pump and use it regularly. I'm 6 yrs post treatment, and I took/take ED meds plus used a pump and other toys. Glad I did.
ADT side effects certainly affect the heart, but if your husband has good heart health going into treatment and the treatment is not long term, he should be fine. ED is another matter...if ED and sexual function are important QoL (quality of life) issue to you or him, then know what your are getting into with HT...
The lady Urologists in the podcast below told me more on what would happen while using ADT and what life would be like with low TET (testosterone) than any male URO I have ever had...there is some good news here but a lot is grim, cold, truth about what to expect. I have been called out by some here that suffered no effects after 6 months of ADT...perhaps the body can take short bouts of ADT, but long term use is not the same. There are serious, permanent impacts of long term ADT use. Men should know what these are. I hope your husband never needs to stay on HT (hormone therapy) longer than 6 months. But if he needs it he must do it...as a Dr somewhere eloquently stated, 'the ultimate side-effect of PCa is death.' So this should always guide us and if we need to choose between ED or the ultimate side effect I guess its no choice...good luck. TNX Rick
I had a RP in 2016, which ended any future erections. However, I use a vacuum pump that produces an erection, and my wife and I are still enjoying great sex 🤗
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